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Non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation by blocking cyclo-oxygenases (COX), enzymes that are needed to produce prostaglandins. Most NSAIDs block two different cyclo-oxygenases, called COX-1 and COX-2. COX-2, found in joint and muscle tissue, contributes to pain and inflammation. Many NSAIDs also block COX-1, which may contribute to development of ulcers and gastrointestinal bleeding depending on the magnitude of blockade. More recently, some NSAIDs have also been associated with an increased risk of serious cardiovascular events, such as myocardial infarction. The purpose of this review is to compare the efficacy, effectiveness, and harms of NSAIDs.
Contents
- Introduction
- Methods
- Results
- Overview
- Key Question 1. Are there differences in effectiveness between coxibs and other NSAIDs?
- Key Questions 2 and 3. Are there clinically important differences in short-term safety or adverse effects between celecoxib, other NSAIDS, or the combination of a nonselective NSAID plus antiulcer medication? Are there clinically important differences in long-term safety or adverse effects between celecoxib, other NSAIDS, or the combination of a nonselective NSAID plus antiulcer medication?
- Key Question 4. Are there subgroups of patients based on demographics, other medications (e.g., aspirin), or co-morbidities for which one medication is more effective or associated with fewer adverse effects?
- Summary
- References
- Appendixes
Suggested citation:
Chou R, Helfand M, Peterson K, Dana T. (2004). Drug Class Review of Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDS). http://www.ohsu.edu/drugeffectiveness
The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.
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- Review The effectiveness of five strategies for the prevention of gastrointestinal toxicity induced by non-steroidal anti-inflammatory drugs: systematic review.[BMJ. 2004]Review The effectiveness of five strategies for the prevention of gastrointestinal toxicity induced by non-steroidal anti-inflammatory drugs: systematic review.Hooper L, Brown TJ, Elliott R, Payne K, Roberts C, Symmons D. BMJ. 2004 Oct 23; 329(7472):948. Epub 2004 Oct 8.
- Review A comparison of the cost-effectiveness of five strategies for the prevention of non-steroidal anti-inflammatory drug-induced gastrointestinal toxicity: a systematic review with economic modelling.[Health Technol Assess. 2006]Review A comparison of the cost-effectiveness of five strategies for the prevention of non-steroidal anti-inflammatory drug-induced gastrointestinal toxicity: a systematic review with economic modelling.Brown TJ, Hooper L, Elliott RA, Payne K, Webb R, Roberts C, Rostom A, Symmons D. Health Technol Assess. 2006 Oct; 10(38):iii-iv, xi-xiii, 1-183.
- Review Dual acting anti-inflammatory drugs: a reappraisal.[Pharmacol Res. 2001]Review Dual acting anti-inflammatory drugs: a reappraisal.Bertolini A, Ottani A, Sandrini M. Pharmacol Res. 2001 Dec; 44(6):437-50.
- Review Anti-inflammatory drugs in the 21st century.[Subcell Biochem. 2007]Review Anti-inflammatory drugs in the 21st century.Rainsford KD. Subcell Biochem. 2007; 42:3-27.
- Drug Class Review: Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inf...Drug Class Review: Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDs)
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